After the fun and indulgence of the holidays, the beginning of the new year is a time to renew our commitment to good health. In addition to getting back to a healthy diet and exercise routine, it should include planning for routine health maintenance and screening. Patients often ask about how often they should have their annual well woman exam because they have heard that the pap test may no longer be needed every year. The short answer is that we still recommend that women over the age of 21 come in for an annual well woman exam every year. We also recommend younger women to come in for family planning, STD screening and HPV prevention, ideally before becoming sexually active.
The pap test is a screening test for cervical cancer and precancerous cells described in 1928 by Dr. Georgios Papanikolaou. It has made early detection possible and deaths from cervical cancer increasingly rare. Many invasive cervical cancers now found in the US occur in women who have never had a pap test, and another significant portion is found in women who have not had one in the past 5 years. We now know that most cervical cancers are caused by the Human Papilloma Virus (HPV), a sexually transmitted virus. Vaccination against this virus is now available and recommended for both women and men between the ages of 9 and 26. It protects against the most common types of HPV which cause cervical cancer and genital warts. Since it doesn’t prevent all cases, and not all eligible young people are getting vaccinated, the pap test will continue to be recommended. We advise women to visit their women’s health provider every year to discuss their individual needs.
The annual well woman exam is much more than the pap test. Depending on a woman’s age, we also discuss family planning, breast cancer screening, general health maintenance, management of menopause symptoms, and bone loss prevention. Family planning may include preventing pregnancy with birth control options or finding out about how to plan ahead for a healthy desired pregnancy. Breast cancer screening has also been a topic of discussion in the news with the addition of genetic testing for women with strong family histories of breast and ovarian cancers. Every woman has a different personal and family history that they should discuss with their women’s health provider at their annual well woman exam.